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The Villages
Thursday, March 28, 2024

Doctor: Villages offers ideal demographics for a successful health system

Whether Villagers should join the new Villages Health System depends on what kind of health care they want.

People who want to be in control of their own care and make decisions with their doctors about treatment and medication may benefit from the system, said Jim Stickel, who offered the second installment of a two-part presentation Monday to the Villages Civil Discourse Club.

Stickel, a former electrical engineer who spent several months studying the new system, said the traditional method of care is to leave decisions to doctors, make an appointment only where there is a problem and not to participate in preventative care.

“Patients are confused, specialist-driven and lazy,” he said, adding that treatment variation for the same disease is wasteful.

Stickel said the health system tries to address some of these problems in traditional health care.

Residents of Lake, Marion and Sumter counties are eligible for the health system if they have acceptable insurance. The system, which eventually is planned to have seven clinics at various locations, accepts several types of insurance, but the most common is MedicareComplete, which comes in health maintenance organization (HMO) and preferred provider organization (PPO) versions.

Dr. Paul Chirlin, a pediatrician who practiced in Ohio before moving to The Villages, said he noticed that most of the health system doctors are family care physicians and few have geriatric or internist training. Family care physicians are trained in a variety of disciplines, including pediatrics and obstetrics, which would not be used much in The Villages.

He said The Villages offers ideal demographics for a successful health system because most of the population is active and healthy seniors who might seek care back home if they have serious health problems. Many of the sickest people are screened out of the system either because they don’t move here in the first place or they will leave if health problems become severe.

Cirlin also spoke about the issue of existing providers in The Villages dropped by United Healthcare, which manages the MedicareComplete insurance for the Villages Health System. United Healthcare also recently dropped thousands of doctors in Florida, Connecticut and possibly other states.

Cirlin said doctors can be dropped by an insurance company for a variety of reasons.

“You either take what they’re willing to pay and the hoops you’re willing to jump through or you don’t,” he said.

He said he once refused to sign a contract with an insurer who required that patients get prior approval from their primary care physician before being transported by helicopter to a hospital emergency room. The requirement was dropped a year later.

The Civil Discourse Club met Monday and talked about health care.
The Civil Discourse Club met Monday and talked about the wide-ranging topic of  health care.

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